Comparing Medical Care in Britain and the US

In late September, AmerisourceBergen, one of the world’s biggest pharmaceutical distribution companies with revenue of $150 billion, was fined $260 million by the US Food and Drug Administration for emptying pre-filled glass syringes of expensive cancer drugs and reloading the drugs, in slightly smaller doses, into cheap plastic syringes before distributing them to oncology centres. For years, the company allegedly pocketed the profits obtained by creating and selling 10 per cent more pre-dosed syringes in this manner. Prosecutors claimed that because the refilling process was not conducted under sterile conditions, it led to ‘floaters’ and bacterial contamination, putting at risk the health of thousands of cancer patients with compromised immune systems.

Earlier this year, the Justice Department filed a lawsuit, based on evidence from a whistleblower, against UnitedHealth Group, the largest provider of subsidised private medical insurance for the elderly, accusing it of overcharging the government by more than $1 billion, by claiming patients were sicker than they actually were.

The FBI estimates that fraud, both private and public, accounts for up to 10 per cent of total US healthcare expenditure, or about $350 billion, of the annual $3.54 trillion that Americans spend on healthcare. The scale of medical fraud in the UK is still small by comparison, but some of the companies that have paid huge fraud fines in the US – including UnitedHealth, McKesson, Celgene and the Hospital Corporation of America – are becoming increasingly involved in NHS privatisation schemes, in accordance with the government’s wishes.

The Health and Social Care Act pushed through by Andrew Lansley as health secretary in 2012 was intended to increase privatisation, outsourcing, inter-regional competition and ‘marketisation’ in an already strained system. There is little sign that it is improving services or reducing costs, but private firms see profits to be made.

My wife and I flew to the UK last summer to see our daughter receive her DPhil at Oxford. On arriving, I found myself increasingly short of breath. Within a few days I was having difficulty, for the first time in my life, walking up gentle slopes or climbing a flight of stairs. A private doctor whom I consulted found my blood oxygen level to be only 91 per cent – a reading one might expect of a person suffering from pneumonia. He also detected fluid in my right lung and swelling in my ankles. He referred me to the John Radcliffe Hospital’s ambulatory assessment unit the next day. For the time being, he said, I could forget flying home.
After years of negative articles in the US media about overworked doctors, cursory exams and brusque support staff, I wasn’t expecting wonders from the NHS. But my experience was quite the opposite…

To read this article in full, please please click here to go to the London Review of Books.

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